BILL ANALYSIS
AB 574
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Date of Hearing: April 21, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 574 (Hill) - As Amended: April 13, 2009
SUBJECT : Health facilities: smoking.
SUMMARY : Extends the prohibition against tobacco use in
workplaces, including hospitals, to include the entire hospital
campus. Specifically, this bill :
1)Prohibits smoking in all areas of a general acute care
hospital and throughout the entire hospital campus, including,
but not limited to, buildings, parking areas, plazas,
vehicles, underground passages, and sidewalks, unless there is
a government-mandated exception.
2)Excludes from the smoking prohibition, public thoroughfares
and sidewalks adjacent to the general acute care hospital but
not owned by the hospital.
3)Requires a general acute care hospital subject to 1) above to
post signs stating that smoking is prohibited on the entire
hospital campus at building entrances and in other conspicuous
locations.
4)Requires new employees of a general acute care hospital
subject to 1) above to be advised of this policy during
orientation and current employees to be informed of this
policy at least 60 days prior to implementation.
5)Permits a general acute care hospital to provide interested
patients, visitors, and staff with information on, or refer
them to, smoking cessation services.
6)Permits a city, county, or city and county to adopt and
enforce additional smoking and tobacco control ordinances,
regulations, or policies that are no less stringent than
applicable standards in this bill.
7)Excludes from the requirements of this bill property owned or
leased by the hospital that is distinct from, and not part of,
the principal medical campus and that is used for nonhealth
care-related purposes.
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8)Declares the intent of this bill to encourage and assist
smokers to quit tobacco and to reduce the associated risks of
tobacco smoke to hospital patients, staff, and visitors.
EXISTING LAW :
1)Prohibits smoking in an enclosed space at a place of
employment including lobbies, waiting areas, elevators,
stairwells, and restrooms that are a structural part of the
building.
2)Exempts the following places from the place of employment
smoking ban:
a) Up to 65% of hotel/motel guest rooms;
b) Up to 25% or 50%, depending on square footage, of
hotel/motel lobbies;
c) Retail or wholesale tobacco shops and private smokers'
lounges;
d) Cabs of trucks or tractors, if nonsmoking employees are
not present;
e) Warehouse facilities, except areas utilized as office
space, with more than 100,000 sq. ft. of total floor space,
and 20 or fewer full-time employees working at the
facility;
f) Theatrical production sites, if smoking is an integral
part of the story;
g) Medical research and treatment sites, if smoking is
integral to the research and treatment being conducted;
h) Private residences, except for those licensed as family
day care homes during hours of operation and in those areas
where children are present;
i) Patient smoking areas in long-term health facilities;
j) Employee break rooms designated by employers for
smoking, provided they meet certain criteria;
aa) Small businesses, with five or fewer full or part-time
employees, that meet specified criteria.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . The author states that hospitalization
for treatment of an acute health problem, particularly for an
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illness related to tobacco use, represents for many patients a
"teachable moment," a time of heightened motivation to
confront an addiction and to quit smoking. The author further
maintains that for hospital professionals and staff who smoke,
expanded workplace smoking restrictions emphasize the
inconvenience of smoking and encourage quitting. The author
argues that smoke free hospital campuses motivate patients,
visitors, and employees to quit tobacco in an environment that
is both supportive and prepared to provide cessation
assistance to smokers.
2)BACKGROUND . According to the sponsors, Breathe California and
the California Tobacco Control Alliance, 73 California
hospitals currently have voluntarily prohibited smoking
throughout their campuses. The Journal of the American
Medical Association (1996) reports 41% of hospitals nationwide
maintain smoking restrictions that are more stringent than
legally required, and 66% of U.S. hospitals now offer smoking
cessation to both employees and patients. The sponsors note
that the Centers for Disease Control and Prevention (2008)
have confirmed that the successful quit ratio is greater for
hospital employees and patients when smoking is restricted.
There are approximately 400 acute care hospitals in
California.
3)SUPPORT . Health Access, writing in support of the bill, noted
that while smoking is already prohibited inside hospitals,
this bill would help smokers quit while also reducing exposure
to second hand smoke. The San Francisco Tobacco Free Coalition
(SFTFC) supports the bill because hospitals can provide
support, assistance and encouragement to help people quit and
hopefully avoid the disease and premature death caused by
tobacco. The SFTFC notes that they supported a smoke-free
campus at San Francisco General Hospital in order to help
their coworkers quit.
4)POLICY COMMENTS.
a) This bill prohibits smoking on the entire hospital
campus, even for patients who are physically addicted to
tobacco but who may be unable to leave the campus. The
author may wish to amend this bill to provide for an
exemption in cases where a patient's physician determines
that denying the patient access to tobacco could impair the
patient's mental health, treatment or recovery.
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b) This bill authorizes local governments to adopt and
enforce additional smoking policies that are "no less
stringent" than the provisions of this bill. Since this
bill enacts a total prohibition against smoking on the
entire hospital campus, it is unclear what additional
requirements local governments would or could impose.
REGISTERED SUPPORT / OPPOSITION :
Support
Breathe California (cosponsor)
California Tobacco Control Alliance (cosponsor)
American Federation of State, County and Municipal Employees
Breathe California of Los Angeles
Coalition of Lavender Americans on Smoking & Health
Health Access California
Indian Health Center of Santa Clara Valley
Public Health Law and Policy Center
Regional Asthma Management and Prevention
San Francisco Asthma Task Force
San Francisco Tobacco Free Coalition
San Mateo Tobacco Education Coalition
Opposition
None on file.
Analysis Prepared by : John Miller/ HEALTH / (916) 319-2097